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QM led research shows potential benefits of e-learning in medical training

International research led by Queen Mary, University of London, suggests that e-learning is an effective method of medical training and could be an affordable way of driving up clinical standards and improving workplace culture.

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The results, published in the Journal of the American Medical Association, suggest that clinically integrated evidence-based medicine (EBM) – which involves clinicians drawing on the latest research and best practice – can improve clinical knowledge and skills when delivered via e-learning methods, such as videos.

This could be of particular significance in developing countries where there is often a scarcity of EBM-trained clinical tutors, lack of protected time for teaching EBM, and poor access to relevant databases in languages other than English.

The randomised trial was conducted between April 2009 and November 2010 among postgraduate trainees in obstetrics-gynaecology in seven low-middle-income-countries (LMICs) – Argentina, Brazil, Democratic Republic of the Congo, India, Philippines, South Africa and Thailand.

The trainees were randomised into two groups, with one group receiving a clinically integrated e-learning course which consisted of five videos where EBM knowledge was delivered by a speaker. The study evaluated the effects on the trainees’ knowledge, skills and educational environment as compared to the control group, who received EBM training via self-directed learning – which involved access to an online slide presentation rather than the videos. The study was completed in 24 experimental clusters (98 participants) and 22 control clusters (68 participants).

After the trial, the experimental group had higher average scores in knowledge and skills. Although there was no difference in improvement for the overall score for educational environment, there was an associated average improvement in measures of general relationships and support and EBM application opportunities.

Khalid Khan, Professor of Women's Health and Clinical Epidemiology at Barts and The London School of Medicine and Dentistry, part of Queen Mary, co-ordinated the study. Professor Khan said: “To our knowledge this is the first time such an effect has been shown in a randomised trial and it demonstrates that trials of educational interventions are feasible.

“Although issues around EBM are of particular relevance in LMIC countries, where there is a scarcity of trained and clinically confident teachers, these results are generalisable to medical education worldwide. The results suggest e-learning is a valid training method for both improving clinical knowledge and skills and also workplace culture, and it could be a cost-effective alternative to face-to-face teaching.”

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